Mediterranean diet as tool to manage obesity in menopause: A narrative review

Menopause is a physiological event in a woman's life characterized by the cessation of spontaneous menstrual cycles caused by a reduction in the sex hormones estrogen and progesterone and a consequent increase of gonadotropins, which occurs when the stocks of ovarian follicles end. Weight gain is a common phenomenon in menopause and age of onset is influenced by several factors. Among modifiable risk factors are sedentary lifestyle and unhealthy nutritional patterns, which often result in obesity that in turn contributes to an increase in cardiovascular risk in menopause, mostly through low-grade inflammation. The Mediterranean diet (MedD) is a healthy dietary pattern characterized by an adequate consumption of vegetables, fruits, whole grains, and legumes with a reduction of saturated animal fats in favor of unsaturated vegetable fats and a high intake of bioactive compounds including polyphenols and ω-3 fatty acids with anti-inflammatory and antioxidant potency. Because of its palatability and long-term sustainability, the MedD, especially if hypocaloric, combined with physical activity, has shown promising results in terms of weight loss in individuals with obesity, as well as similar beneficial effects in menopause-related obesity. It has been observed that greater adherence to the MedD in menopause is associated with reduced risk for becoming overweight/obese, better cardiometabolic profile, and an improvement in menopausal symptoms. Although it is necessary to confirm these data with future large intervention trials, the MedD can be considered a safe and healthy approach in the management of menopause-related obesity and its cardiometabolic complications.